SYSTEM-LEVEL EFFECTS OF DEVICE-BASED MULTISENSORY MONITORING IN HEART FAILURE: A REAL-WORLD ANALYSIS OF CARE DELIVERY, HEALTHCARE COSTS, ENVIRONMENTAL SUSTAINABILITY, AND WORKFORCE
Author(s)
Anne Catherine M. van der Lande, MSc1, Bart J.A. Mertens, PhD2, Martin Jan Schalij, PhD, MD2, Saskia L.M.A. Beeres, PhD, MD2.
1PhD and Director, Leiden University Medical Center (LUMC), Leiden, Netherlands, 2Leiden University Medical Center (LUMC), Leiden, Netherlands.
1PhD and Director, Leiden University Medical Center (LUMC), Leiden, Netherlands, 2Leiden University Medical Center (LUMC), Leiden, Netherlands.
OBJECTIVES: Although multisensory cardiac implantable electronic device (CIED)-based monitoring improves clinical outcomes in patients with heart failure (HF), its system-level value remains poorly understood. This study evaluated the system-level value of algorithm-guided CIED monitoring through an integrated assessment of healthcare resource utilisation, healthcare costs, environmental sustainability and workforce requirements in real-world clinical practice.
METHODS: We performed a system-level analysis of a previously reported real-world propensity score-matched cohort of 191 matched pairs of adult HF patients with a CIED, comparing algorithm-guided multisensory monitoring (HeartLogic or TriageHF) with standard care. Healthcare utilisation data were translated into healthcare costs, carbon emissions, and workforce requirements using validated economic, environmental, and workload models from a healthcare system perspective.
RESULTS: Compared with standard care, algorithm-guided CIED monitoring was associated with fewer HF-related hospitalisations (RR 0.44) and emergency department visits (RR 0.23). These reductions, primarily driven by lower hospital utilisation, translated into 36.6% lower annual healthcare costs (€860 vs €1,356 per patient-year; cost ratio 0.63, 95% CI 0.45-0.90; p=0.009) and 39.8% lower healthcare-related carbon emissions (33.0 vs 54.8 kg CO₂-eq per patient-year; emission ratio 0.60, 95% CI 0.38-0.95; p=0.029). Cardiologist workload decreased (0.443 vs 0.510 hours per patient-year; RR 0.87, p=0.043), whereas HF nurse workload increased (0.622 vs 0.246 hours per patient-year; RR 2.53, p<0.001), indicating redistribution of care toward proactive remote management rather than increased healthcare utilisation.
CONCLUSIONS: Algorithm-guided CIED monitoring delivered system-level value by reducing healthcare costs and carbon emissions while enabling a shift from hospital-based, physician-led care toward proactive, nurse-led remote care delivery. These findings demonstrate that multisensory CIED monitoring generates value beyond clinical outcomes by supporting more efficient, scalable, and sustainable delivery of chronic HF care.
METHODS: We performed a system-level analysis of a previously reported real-world propensity score-matched cohort of 191 matched pairs of adult HF patients with a CIED, comparing algorithm-guided multisensory monitoring (HeartLogic or TriageHF) with standard care. Healthcare utilisation data were translated into healthcare costs, carbon emissions, and workforce requirements using validated economic, environmental, and workload models from a healthcare system perspective.
RESULTS: Compared with standard care, algorithm-guided CIED monitoring was associated with fewer HF-related hospitalisations (RR 0.44) and emergency department visits (RR 0.23). These reductions, primarily driven by lower hospital utilisation, translated into 36.6% lower annual healthcare costs (€860 vs €1,356 per patient-year; cost ratio 0.63, 95% CI 0.45-0.90; p=0.009) and 39.8% lower healthcare-related carbon emissions (33.0 vs 54.8 kg CO₂-eq per patient-year; emission ratio 0.60, 95% CI 0.38-0.95; p=0.029). Cardiologist workload decreased (0.443 vs 0.510 hours per patient-year; RR 0.87, p=0.043), whereas HF nurse workload increased (0.622 vs 0.246 hours per patient-year; RR 2.53, p<0.001), indicating redistribution of care toward proactive remote management rather than increased healthcare utilisation.
CONCLUSIONS: Algorithm-guided CIED monitoring delivered system-level value by reducing healthcare costs and carbon emissions while enabling a shift from hospital-based, physician-led care toward proactive, nurse-led remote care delivery. These findings demonstrate that multisensory CIED monitoring generates value beyond clinical outcomes by supporting more efficient, scalable, and sustainable delivery of chronic HF care.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE155
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)